Invega Sustenna, made simple.
Invega Sustenna is a long-acting medicine for schizophrenia and schizoaffective disorder. Instead of a daily pill, it is one injection a month, given by your care team. This guide explains how it works, what to expect, and what to watch for. A Mississippi pharmacist wrote it for you, with care.
This guide is here to teach you. It is not medical advice, and it does not replace your doctor or pharmacist. Always do what your doctor tells you, and ask a pharmacist before you change how you take any medicine.
Print this guide for your fridgeWhat Invega Sustenna is and why your doctor gave it to you
Invega Sustenna is a medicine for schizophrenia and for schizoaffective disorder in adults. Its other name is paliperidone palmitate.
It is a long-acting injection. That is the key idea. Instead of remembering a pill every single day, you get one injection, given by a nurse or your provider, about once a month. The medicine then releases slowly over the weeks between visits.
For many people this is a relief. A once a month injection takes the daily pressure off, and it means the medicine stays steady in your body without depending on a perfect daily routine.
The simple version: Invega Sustenna is a once a month injection that helps keep symptoms steady and lowers the chance of a relapse. Steady treatment is what protects the progress you have made.
How Invega Sustenna works
Schizophrenia and schizoaffective disorder involve brain chemicals, especially one called dopamine, being out of balance.
Invega Sustenna helps bring that signaling back toward balance. It works on dopamine and on another brain chemical called serotonin, settling the signals that, when they run too high or too low, cause symptoms.
Because it is given as a long-acting injection, the medicine is released a little at a time over the month. There are no peaks and dips from forgetting or doubling a pill. That steady level is part of why a monthly injection can work so well.
Your dose, and how the injections work
Invega Sustenna is given by your care team, not by you at home. Your doctor decides your dose. This page will not tell you what dose you should be on.
There is one thing worth knowing about the start. Before the very first Invega Sustenna injection, your doctor will usually have you try the medicine in pill form for a short time. This simply checks that you tolerate it well before switching to the long-acting shot.
The first two injections come close together, often about a week apart. These are starter doses, and they build the medicine up to a steady level quickly. After that, it settles into one injection about once a month. The first injections go into the shoulder muscle, and later ones can be the shoulder or the buttock.
Your monthly appointment, and what to do if you miss one
Because Invega Sustenna is given on a schedule by your care team, the most important habit is simple: keep your injection appointments. Put each one on your calendar before you leave the clinic.
If you have to miss an appointment, the most important thing is what to do next.
If you miss a dose:
- If you cannot make an injection appointment, call your clinic right away. Do not just wait for the next month.
- What your care team does depends on how much time has passed since your last injection, so the sooner they know, the simpler the fix.
- Missing injections can let symptoms return. Catching it early keeps you steady.
- Fairview can help too. If a cost or supply issue is making an appointment hard, call us before the date, not after.
Side effects, what is normal and what is not
Common, and usually manageable.
- Soreness, swelling, or a firm spot where the injection was given. This usually settles in a few days.
- Feeling drowsy or sleepy.
- Some weight gain.
- Restlessness, or a feeling that you need to keep moving. Tell your care team if this happens, it can be managed.
Call your doctor if you notice:
- Signs of higher blood sugar, like being very thirsty, urinating a lot, or being very hungry.
- Notable weight gain.
- Feeling dizzy or faint, especially when you stand up.
- New movements you cannot control, such as of the face, tongue, or hands.
Go to the emergency room right away if:
- You have a high fever, very stiff muscles, sweating, and confusion all together. This is a rare but serious reaction that needs care now.
- You have a fast or irregular heartbeat, or you faint.
- You have a fever with a sore throat and mouth sores, which can be a sign your body is not making enough infection-fighting cells.
What to be careful with
A few kinds of medicine need a careful look alongside Invega Sustenna. The main ones are other medicines that can affect heart rhythm, certain seizure medicines, some blood pressure medicines, and the herbal supplement St. John's Wort.
This is not a list to memorize. It is a reason to do one simple thing.
The simple rule: tell every doctor and every pharmacist that you get Invega Sustenna injections, and before you start any new medicine or supplement, including anything you buy without a prescription, mention it. Every single time.
Alcohol is worth a word too. Both alcohol and this medicine can make you drowsy and unsteady, so combining them increases that effect. Ask your care team what is sensible for you. At Fairview, we keep your medicine list and check new prescriptions against it.
What it costs
The cost is different for every person, because every insurance plan is different.
Here is the honest way to find your price. If you pay cash, call Fairview and we will give you a price for your situation. If you have private insurance, there may be a coupon or a savings program from the maker of the drug that helps lower your cost, and we will check if one is available for you. The best step is to let a pharmacist look at your plan. We do this for every patient.
Do not let cost make you skip doses. Call us first. There is almost always something we can do.
There is also a generic version of many medicines. The generic is the same medicine. Ask your pharmacist if a generic is a good fit for you.
What should be checked
Invega Sustenna works best alongside some regular checks. These keep you safe and help your team see that the medicine is doing its job.
Your doctor should check, now and then:
- Your weight, your blood sugar, and your cholesterol.
- How well your kidneys are working.
- Your blood pressure, including whether you feel dizzy standing up.
- Any new movements you cannot control.
Your pharmacist can help by:
- Keeping your full medicine list and checking new prescriptions against it.
- Answering questions about side effects between appointments.
- Helping with cost and assistance programs.
- Keeping your information private, always.
At Fairview, we keep an eye on our Invega Sustenna patients between appointments. If something comes up, you can call us. Your care is handled discreetly and with respect.
Special situations
Not for older adults with dementia.
There is an FDA warning that all medicines in this group, including Invega Sustenna, raise the risk of death when used in older adults who have dementia. Invega Sustenna is approved for schizophrenia and schizoaffective disorder, not for dementia. If a loved one with dementia has been prescribed it, ask the prescriber about this directly, so the decision is made with full information.
Keeping your appointments.
The single most useful thing you can do on Invega Sustenna is to keep your monthly injection appointments. Each one keeps your treatment steady. If a date is hard to make, because of a ride, work, or cost, call your clinic or Fairview ahead of time and let us help you sort it out.
Driving and machinery.
This medicine can cause drowsiness, dizziness, or slower thinking, especially at first. Until you know how it affects you, do not drive or use heavy machinery. This often eases as your body adjusts.
If you have kidney problems.
How well your kidneys work affects this medicine. If your kidney function is reduced, your doctor adjusts the dose, and if it is significantly reduced, a different treatment may be chosen. Make sure your prescriber knows about any kidney condition.
Pregnancy.
If you are pregnant, planning to become pregnant, or breastfeeding, tell your doctor. Babies exposed to antipsychotic medicines late in pregnancy can have muscle stiffness or withdrawal signs after birth. This does not mean treatment stops, it means it is planned carefully with your doctor.
Cost should never be the reason you stop.
This medicine is expensive at full price, but there is real help. There are manufacturer savings programs, and for people with limited income there are assistance programs that can provide it at low or no cost. If cost is a worry, call Fairview before you miss an appointment.
How Fairview helps Invega Sustenna patients
When Fairview is part of your Invega Sustenna care, here is what you get. This is normal care for us, and it is always private.
When you start:
- We check all your other medicines and supplements against Invega Sustenna.
- We explain what to expect from the first injections.
- We talk through cost and help you find any program you qualify for.
Along the way:
- We answer questions about side effects between appointments.
- We check any new prescription against your medicine list.
- We help you keep your supply and your appointments on track.
On our own, without being asked:
- If we see a medicine that does not mix well, we call your doctor.
- We check your cost regularly to keep it as low as possible.
- We keep your care discreet and respectful, always.
Questions people ask about Invega Sustenna
It treats schizophrenia and schizoaffective disorder in adults. Instead of a daily pill, it is given as an injection about once a month by your care team, so there is no daily medicine to remember.
Related guides
Have a question about your Invega Sustenna? Ask a pharmacist you can trust.
Staying steady on treatment is a real achievement, and a once a month injection makes that easier to keep. Fairview is here to support you and your family through it, privately and without judgment. If something made you wonder, ask us.